{"doi":"10.1176/appi.prcp.20220036","title":"Interactions Between Neuropsychiatric Symptoms and Alzheimer's Disease Neuroimaging Biomarkers in Predicting Longitudinal Cognitive Decline","abstract":"Objective: To examine interactions between Neuropsychiatric symptoms (NPS) with Pittsburgh Compound B (PiB) and fluorodeoxyglucose positron emission tomography (FDG-PET) in predicting cognitive trajectories. Methods: We conducted a longitudinal study in the setting of the population-based Mayo Clinic Study of Aging in Olmsted County, MN, involving 1581 cognitively unimpaired (CU) persons aged ≥50 years (median age 71.83 years, 54.0% males, 27.5% APOE ɛ4 carriers). NPS at baseline were assessed using the Neuropsychiatric Inventory Questionnaire (NPI-Q). Brain glucose hypometabolism was defined as a SUVR ≤ 1.47 (measured by FDG-PET) in regions typically affected in Alzheimer's disease. Abnormal cortical amyloid deposition was measured using PiB-PET (SUVR ≥ 1.48). Neuropsychological testing was done approximately every 15 months, and we calculated global and domain-specific (memory, language, attention, and visuospatial skills) cognitive z-scores. We ran linear mixed-effect models to examine the associations and interactions between NPS at baseline and z-scored PiB- and FDG-PET SUVRs in predicting cognitive z-scores adjusted for age, sex, education, and previous cognitive testing. Results: Individuals at the average PiB and without NPS at baseline declined over time on cognitive z-scores. Those with increased PiB at baseline declined faster (two-way interaction), and those with increased PiB and NPS declined even faster (three-way interaction). We observed interactions between time, increased PiB and anxiety or irritability indicating accelerated decline on global z-scores, and between time, increased PiB and several NPS (e.g., agitation) showing faster domain-specific decline, especially on the attention domain. Conclusions: NPS and increased brain amyloid deposition synergistically interact in accelerating global and domain-specific cognitive decline among CU persons at baseline.","journal":"Psychiatric Research and Clinical Practice","year":2023,"id":343852,"datarank":0.5826849769839431,"base_score":2.639057329615259,"endowment":2.639057329615259,"self_citation_contribution":0.3958585994422889,"citation_network_contribution":0.18682637754165415,"self_endowment_contribution":0.3958585994422889,"citer_contribution":0.18682637754165415,"corpus_percentile":null,"corpus_rank":null,"citation_count":13,"citer_count":11,"citers_with_citation_signal":8,"citers_with_endowment":8,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8118,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":461078,"name":"Janina Krell‐Roesch","orcid":"0000-0003-4011-9842","position":1,"is_corresponding":false},{"id":253902,"name":"Jeremy A. Syrjanen","orcid":"0000-0001-5990-8206","position":2,"is_corresponding":false},{"id":1074308,"name":"Luke R. Christenson","orcid":null,"position":3,"is_corresponding":false},{"id":259159,"name":"Val J. Lowe","orcid":"0000-0002-5612-1667","position":4,"is_corresponding":false},{"id":226058,"name":"Prashanthi Vemuri","orcid":"0000-0003-4286-0589","position":5,"is_corresponding":false},{"id":253904,"name":"Julie A. Fields","orcid":"0000-0002-1282-9866","position":6,"is_corresponding":false},{"id":393527,"name":"Gorazd B. Stokin","orcid":"0000-0001-8430-8755","position":7,"is_corresponding":false},{"id":253903,"name":"Walter K. Kremers","orcid":"0000-0001-5714-3473","position":8,"is_corresponding":false},{"id":436233,"name":"Eugene Scharf","orcid":"0000-0003-2928-3924","position":9,"is_corresponding":false},{"id":49956,"name":"Clifford R. Jack","orcid":"0000-0001-7916-622X","position":10,"is_corresponding":false},{"id":49955,"name":"David S. Knopman","orcid":"0000-0002-6544-066X","position":11,"is_corresponding":false},{"id":27599,"name":"Ronald C. Petersen","orcid":"0000-0002-8178-6601","position":12,"is_corresponding":false},{"id":461079,"name":"Maria Vassilaki","orcid":"0000-0001-8328-136X","position":13,"is_corresponding":false},{"id":461080,"name":"Yonas E. Geda","orcid":"0000-0003-1187-7230","position":14,"is_corresponding":false},{"id":685658,"name":"Anna Pink","orcid":null,"position":0,"is_corresponding":true}],"reference_count":51,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T01:11:26.556051Z","pmid":"36909142","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}